Walking: Why It Is So Complicated

By: Dr. Beth Templin

Walking is a skill many take for granted. We often forget how much strength, balance, and coordination this daily task takes to accomplish effortlessly. A decline in any of these areas can result in an uncoordinated walking pattern, resulting in slips, trips, and falls.

The seemingly simple task of walking is a beautiful sequence of many smaller movements that rely on timing and accuracy to create smooth motion. For example, you need to be able to shift all of your weight onto one leg to pick your other foot up off of the floor and move it forward. As you begin to lose strength, particularly in your hips, this activity becomes more challenging. When this happens, we typically see shorter and smaller shuffling-type steps. This places the person at a higher risk of having a fall.

Other changes we see in walking are a decrease in arm swings. With normal walking, your right arm should swing forward as you take a step with your left leg. This pattern helps you to stay steady on your feet. As balance declines, many people hold their arms at their sides in an attempt to add stability to their trunk. This is often an indicator of core weakness and balance changes. 

We also see more of a "flat foot" walking pattern with age, where the entire foot hits the ground at the same time. This is usually due to weakness or stiffness in the ankles and can not only increase pain, but increase falls as well.

"Normal" walking instead uses a heel-toe walking pattern, where the heel hits the ground first and then the weight moves forward through the middle of the foot and then you push off from the toes. The benefit of a heel-toe walking pattern is that the heel is designed to absorb the impact of each step you take, lessening the impact on your hips, knees, and spine. This helps lessen arthritis aches. You are also less likely to stub your toe when you use this approach, decreasing your risk of a fall.

Decreased walking speed is more common with age. Walking speed is an indicator of our overall health. Walking speed is a simple test that captures your balance, strength, coordination, and endurance. Studies support that the faster you walk, the longer you live. Conversely, the slower you walk, the more likely you are to have health issues, end up in the hospital and even die. In the geriatric world, we think of walking speed as another vital sign, similar to pulse and blood pressure. We can use this measurement to get a snapshot of your overall physical health.

Decreased step height is another change we see in walking. As your strength, balance, and coordination decrease, you end up not lifting your foot as high with each step you take. This is to try to limit the amount of time you are standing on one leg, while the other foot moves forward.
The good news is all of these changes are reversible with the right kinds of exercise. We recommend seeking out a physical therapist as soon as you start to notice you or a loved one is experiencing any of the changes in this article.

Check out Dr. Kim's exercise of the month HERE to stay ahead of the game. This month she teaches an activity that will help to improve your step height, leg strength, coordination, balance, and endurance! It's a great one to help cover many of the bases needed to maintain normal walking as you age.

​❤ Dr. Beth

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